The conventional method of prostatectomy may be classified into the following four methods; the perineal prostatectomy, the suprapubic transvesical prostatectomy, the retropubic prostatectomy, and the transurethral resection of prostate which so-called TUR-P. Among these four methods, the last method is the only method which incorporates the endoscope. Nowadays, about 90% of the prostatectomy that are performed use the technique of transurethral method to resect the prostate, which is a well-known method.
The conventional device for the transurethral resection of prostate is a commercially available device which is a manual-type resectoscope in which the electrotome is made from a high resistivity metal wire, such as the tungsten wire or nickle-chrome alloy wire, with the electrotome having a semi-circular shape and perpendicular to the loop electrode. In operation, the electrotome is heated electrically by applying an electrical voltage across the wire which is used to resect the prostate. An operation performed using this device requires a mechanical scratch of the resectoscope to cut away the unwanted part of the tissue. This mechanical scratching process is controlled manually by the operator.
One of the disadvantages of this conventional device is that the operation is very slow because the mechanical scratching process is employed and the resecting process is a one-cut by one-cut process instead of a continuous cutting process. It usually takes at least half an hour for a skilled operator to finish an operation. Such a slow resection is certainly undesirable because it causes a long period of bleeding at the resecting portion and produces more complications for the patient, and also limits the operable number of patients in a given time interval. This leads to a high operation cost per resection.
Another disadvantage of this conventional device is that the scratching cutting process involves a large angle movement of the resectoscope, controlled by the hands of the operator and is therefore not precise and may potentially cut through the prostate capsule and external sphincter. This may lead to complications of capsule perforation and urination incontinence after the operation. The patient may need further operations or reconstructive procedures which may seriously injure the patient morally and physically.